Appropriateness of referring for colonoscopy: results from a cross-sectional study in primary care.
Appropriateness of referring for colonoscopy: results from a cross-sectional study in primary care.

Summary/Abstract: Background: Colorectal cancer (CRC) is the third most commonly diagnosed malignant cancer and the fourth leading cause of cancer-related death in the world. The role of family doctors in the diagnosis and management of gastrointestinal disorders, including screening for CRC, is crucial. Aim of the study: To examine the appropriateness of colonoscopy referrals in a primary healthcare setting. Material and methods: The clinical reports of all colonoscopies ordered during 2017 at a primary care center (317 in total) were examined. The reasons for referral, the findings of the colonoscopies, and the pathology of identified polyps were extracted from the reports and summarized. Results: The patients included 161 males (50.8%) and 156 females (49.2%) with a mean age of 63.6 years. The most frequent reasons for ordering a colonoscopy were a personal history of polyposis/CRC (n=94, 29.7%), rectal bleeding (n=57, 18%) and anemia (n=35, 11%). Only 67 (21%) of the colonoscopies performed showed a normal result, whereas 250 (79%) had abnormal findings. The main findings of the colonoscopies were polyps (n=119, 37.5%), diverticulosis (n=61, 19.2%) and hemorrhoids (n=37, 11.7%). The main results for polyp pathology were tubular adenoma with low-grade dysplasia (n=70, 58.8%), hyperplastic polyp (n=27, 22.7%), adenocarcinoma (n=9, 7.6%) and inflammatory polyp (n=4, 3.4%). Colorectal cancer was found in a total of 14 (4.4%) patients. Conclusions: The referral for colonoscopy by family doctors is appropriate.

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